Keloids are scars that don’t stop growing
DEAR DR. DONOHUE: What can be done for a very bothersome scar on a teenager’s leg? — L.M.
ANSWER: If you could be a trifle more specific, I could be sure if my answer applies to you. If it doesn’t, write me again.
A keloid is a scar that keeps growing when it should have stopped. It spreads far beyond the borders of the original wound. Not only is the scar far too wide, it is raised above the surface of the skin. It might hurt, itch or burn. Scars are made of collagen, the body’s favorite filler material. With a keloid, the body’s collagen production has gotten way out of line.
Keloids are approached in a number of ways. Sometimes doctors choose to inject them on a monthly basis with a cortisone drug. It can take up to six injections to shrink the scar. Or the doctor can use a freezing treatment on them. Liquid nitrogen is the usual agent chosen. The application is done in a series of monthly treatments, and the number of treatments is three or more. Keloids also can be cut out. The new wound has to be treated with great care so that another keloid doesn’t form. Cortisone injections are often employed to stop the keloid from coming back. And lasers also have found a place in keloid treatment.
A hypertrophic scar looks like a keloid. It is large and unsightly, but it doesn’t spread past the original boundaries of the wound. These scars frequently flatten on their own within six months or so.
Did I strike out on this question, L.M.?
DEAR DR. DONOHUE: Will you please explain about factor five? I am 87 and found out I have it. I found out when my oldest son discovered he had it. I did have a knee replacement and had a blood clot in my lung after the surgery. My son says it was because of factor five. — H.B.
ANSWER: Factor five is written as factor V (Roman numeral five) Leiden (the city in the Netherlands where it was discovered).
Most people don’t sit around and mull over how they make blood clots. However, the process is quite amazing and quite important. Involved in clot formation are a group of proteins called clotting factors and another group of proteins that stop clotting factors from overdoing clot-making. Ordinary factor V aids in clotting. It has a counterpart that stops it from going overboard and keeps matters in balance. People born with factor V Leiden have a mutated form of clotting factor V, and they tend to form clots when they should not. The counterpart that stops the action of normal factor V has no effect on it. Your factor V Leiden might have been responsible for the lung clot you had after knee surgery.
This genetic quirk is found in 5 percent of the white population. It’s rarely found in other ethnic groups. People with only one factor V Leiden gene are at a slightly higher-than-normal risk for making unneeded clots. People with two genes are a greater risk.
Clots due to the mutant factor V Leiden most often occur later in life. Young women with the mutation should not take birth-control pills. They add to the danger of clotting. A clot like you had is treated with blood thinner. Those with factor V Leiden who have repeated clots might have to stay on blood thinner for life. Those people are few in number.
DEAR DR. DONOHUE: How long can you store an opened and covered can of food in the fridge?
My daughter insists I throw them out, as they are unsafe. I think the cans are safer than storing food in a bowl. — G.C.
ANSWER: It’s safe to do as you do. Such food storage is unlikely to harm anyone.
However, oxygen gets at food in an opened can and speeds the degradation of the can’s lining. After a few days, food so stored can take on a metallic taste. That’s especially the case if the food is on the acid side, like tomatoes and tomato products.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.